Diagnostic Performance of Axillary Ultrasound in Breast Cancer

The status of axillary lymph nodes is one of the most important prognostic factors among patients with invasive breast cancer. Our objective was to determine the performance of axillary ultrasound imaging in our institution for the detection of metastatic axillary lymph nodes at the time of presentation of invasive breast cancer. A total of 530 patients with breast tumors less than or equal to 5 cm with clinically negative axillary lymph nodes were assessed by imaging specialists. Any lymph node with diffuse cortical thickening greater than 3.5 mm, cortical lobulation and/ or displacement of hilar contour, total hilar replacement, and/or peripheral lymph node vascularity was considered suspicious for malignancy. When suspicious axillary lymph nodes were found, an ultrasound-guided axillary biopsy, a selective sentinel lymph node biopsy and/or axillary lymphadenectomy were performed. We achieved a sensitivity of 67.11% and a specificity of 97.88%. Axillary ultrasound scanning is sensitive and specific in detecting metastatic lymph nodes in patients with clinically negative axillary breast cancer.